Cardiac Surgery in Indigenous Australians - How Wide is 鈥楾he Gap鈥?

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• 作者：Paul Wiemers ; MBBS^a ; ^b ; ^{paul_wiemers@health.qld.gov.au" class="auth_mail} ; ^{pwiemers@bigpond.net.au" class="auth_mail} ; Lucy Marney ; MBBS^a ; Reinhold Muller ; PhD^c ; Matthew Brandon ; MBBS^a ; Praveen Kuchu ; MBBS^a ; Kasandra Kuhlar ; MBBS^a ; Chimezie Uchime ; MSc ; MBBS^a ; Dong Kang ; FRACS^a ; Nicole White ; PhD^d ; Rachel Greenup ; BN^e ; John F. Fraser ; PhD ; FCICM^b ; ^f ; Sumit Yadav ; FRACS^a ; Robert Tam ; FRACS^a
• 关键词：Cardiac surgical procedures ; Indigenous population ; Rheumatic heart disease ; Coronary artery disease ; Australia ; Outcomes
• 刊名：Heart, Lung and Circulation
• 出版年：March, 2014
• 年：2014
• 卷：23
• 期：3
• 页码：265-272
• 全文大小：284 K

文摘

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Background

Cardiovascular disease remains the leading cause of mortality in the Indigenous Australian population. Limited research exists in regards to cardiac surgery in the Aboriginal and Torres Strait Islander (ATSI) population. We aimed to investigate risk profiles, surgical pathologies, surgical management and short term outcomes in a contemporary group of patients.

Methods

Variables were assessed for 557 consecutive patients who underwent surgery at our institution between August 2008 and March 2010.

Results

19.2% (107/557) of patients were of Indigenous origin. ATSI patients were significantly younger at time of surgery (mean age 54.1 卤 13.23 vs. 63.1 卤 12.46; <em>pem> = <0.001) with higher rates of preventable risk factors. Rheumatic heart disease (RHD) was the dominant valvular pathology observed in the Indigenous population. Significantly higher rates of left ventricular impairment and more diffuse coronary artery disease were observed in ATSI patients. A non-significant trend towards higher 30-day mortality was observed in the Indigenous population (5.6% vs. 3.1%; <em>pem> = 0.244).

Conclusions

Cardiac surgery is generally required at a younger age in the Indigenous population with patients often presenting with more advanced disease. Despite often more advanced disease, surgical outcomes do not differ significantly from non-Indigenous patients. Continued focus on preventative strategies for coronary artery disease and RHD in the Indigenous population is required.